Acute Retroviral Syndrome and Seroconversion

Oct 30, 1996

Dear Dr. Gallant, If a person infected with HIV experiences acute
retroviral
syndrome, does that mean that s/he is in the
process of seroconverting? Would a standard HIV antibody test given two
weeks
after recovering from acute retroviral
syndrome usually return a positive, or an indeterminate (but not
negative)
result? that a p24 antigen test would be positive
during acute retroviral syndrome. I have also read that a p24 usually
shows
positive about a week before an ELISA test
shows shows positive. Therefore, wouldn't two weeks be enough time to
show
seroconversion (via a positive ELISA result)
if the person had indeed undergone acute retroviral syndrome? Thank you
for all
of your help.

Response from Dr. Gallant

Yes, someone with the acute retroviral syndrome is in the process of
seroconverting. The best blood test to diagnose someone during that
stage is a
p24 antigen, a viral load test (HIV RNA), or the HIV DNA PCR.

After recovery from the acute retroviral syndrome, the viral load may
fall and
the p24 antigen may become negative. The HIV serology, which is likely
to be
indeterminate or negative during the syndrome, now becomes increasingly
likely
to be indeterminate or positive with time. If it is indeterminate, then
it
should turn positive within a month.

Your statement that the p24 antigen would be positive only one week
before the
ELISA sounds wrong to me. The interval is longer than a week. Therefore,
while
it's likely that the serology should be indeterminate or positive within
two
weeks of the acute retroviral syndrome, it would probably not be true
100% of
the time.

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